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Entrustable professional activities (EPAs) for undergraduate medical education: development and exploration of social validity
Faculty of Medicine, Faculty of Odontology, Lund University, Malmö University, Malmö, Sweden.ORCID iD: 0000-0002-5791-356X
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Department of Clinical Sciences, Futurum - the Academy for Health and Care, Region Jönköping County, Sweden.ORCID iD: 0000-0003-2547-1151
Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden; Department of Medicine, University of Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID iD: 0000-0001-5071-4915
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.ORCID iD: 0000-0002-5590-8601
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2023 (English)In: BMC Medical Education, E-ISSN 1472-6920, Vol. 23, no 1, article id 635Article in journal (Refereed) Published
Abstract [en]

Background: The development of entrustable professional activities (EPAs) as a framework for work-based training and assessment in undergraduate medical education has become popular. EPAs are defined as units of a professional activity requiring adequate knowledge, skills, and attitudes, with a recognized output of professional labor, independently executable within a time frame, observable and measurable in its process and outcome, and reflecting one or more competencies. Before a new framework is implemented in a specific context, it is valuable to explore social validity, that is, the acceptability by relevant stakeholders.

Aim: The aim of our work was to define Core EPAs for undergraduate medical education and further explore the social validity of the constructs.

Method and material: In a nationwide collaboration, EPAs were developed using a modified Delphi procedure and validated according to EQual by a group consisting of teachers nominated from each of the seven Swedish medical schools, two student representatives, and an educational developer (n = 16). In the next step, social validity was explored in a nationwide survey. The survey introduced the suggested EPAs. For each EPA, the importance of the EPA was rated, as was the rater’s perception of the present graduates’ required level of supervision when performing the activity. Free-text comments were also included and analyzed.

Results: Ten Core EPAs were defined and validated. The validation scores for EQual ranged from 4.1 to 4.9. The nationwide survey had 473 responders. All activities were rated as “important” by most responders, ranging from 54 to 96%. When asked how independent current graduates were in performing the ten activities, 6 to 35% reported “independent”. The three themes of the free text comments were: ‘relevant target areas and content’; ‘definition of the activities’; and ‘clinical practice and learning’.

Conclusion: Ten Core EPAs were defined and assessed as relevant for Swedish undergraduate medical education. There was a consistent gap between the perceived importance and the certainty that the students could perform these professional activities independently at the time of graduation. These results indicate that the ten EPAs may have a role in undergraduate education by creating clarity for all stakeholders.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 23, no 1, article id 635
Keywords [en]
Entrustable professional activities, Development, Social validity
National Category
Clinical Medicine Other Medical Sciences not elsewhere specified Educational Sciences
Identifiers
URN: urn:nbn:se:umu:diva-214135DOI: 10.1186/s12909-023-04621-6PubMedID: 37667366Scopus ID: 2-s2.0-85169664954OAI: oai:DiVA.org:umu-214135DiVA, id: diva2:1794486
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Malmö UniversityAvailable from: 2023-09-05 Created: 2023-09-05 Last updated: 2024-04-11Bibliographically approved

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Alm, StinaHultin, MagnusSjälander, Anders

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